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| Greg and I at the beginning of our next adventure in life |
After Sara's pretty much uneventful birth, things continued along pretty much uneventfully. Because I had gestational diabetes, poor Sara had to have her heal pricked every hour or so to check her blood sugar levels. Fortunately, her levels were always perfect! I breathed a sigh of relief each time. I was moved from the recovery area to a family suite, the kids came to meet Sara, and I settled in for a few quiet days in the hospital of cuddling and nursing and sleeping.
Then Sara turned yellow. Like radioactive glowing yellow. And it started after just twelve hours. This was not good.
So here's what happened, the best I can explain it. You have to remember that science is my least favorite subject and blood grosses me out--hence no medical background--AND I was on some serious narcotics during this experience SO I might not be the ultimate authority here. I apologize if I don't have this quite right...
We all have some dead red blood cells in our bodies. The liver turns them into bilirubin and then breaks down the bilirubin. Before babies are born, the placenta does this job for them. It's not until after they are born that their livers begin to do this. It takes time for a baby's liver to get going, so the bilirubin, which is yellow, builds up, giving the baby jaundice. It's perfectly normal for babies to get jaundice, and it usually peaks at about day 4 and resolves on its own. Sometimes babies need extra help breaking down the bilirubin, which can also be broken down with light, so parents may be asked to put their babies in sunlight or under special lights.
As I mentioned, jaundice usually peaks on day 4. So when Sara started turning yellow at just twelve hours of age and was bright canary by 24 hours, it couldn't be good.
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| Sara at just a few hours old. Pinkish white skin. |
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| Sara at 24 hours old. A carrot! |
In Sara's case, it was more serious. Quite serious, in fact. She and I have mismatched blood types, and in this case, with my O+ blood and her A+ blood, it caused problems. Specifically, Sara had a load of dead red blood cells in her body, so her bilirubin levels went through the roof. Her little body couldn't process and expel the bilirubin. If bilirubin levels get too high, it causes brain damage. Her levels were definitely on the trajectory to a dangerous level.
Now, without treatment, the situation would have become scary and dangerous. But she was going to receive treatment, and treatment works, so the situation wasn't really that scary. The treatment was going to work, and she was going to get the treatment, so she was going to be okay. She was always going to be okay, so there wasn't really anything to worry about. Does that make sense? This was one of those situations where there wasn't a lot of uncertainty. For which I am (and was) very grateful. The only question was how long the treatment was going to take.
In Sara's case, extreme treatment (i.e. blood transfusions) wasn't needed. Phew. For her, treatment was 24-7 phototherapy (to break down the bilirubin) and plenty to eat (to flush it out of her system). The moment the doctor saw how high her levels were, she was immediately placed in a bed with special blue UV lights above, below, and beside her. She was surrounded by lights.
But I wanted her to be surrounded by my arms.
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| Our "bili-baby" in her "bili-bed" |
That was the hard part, not holding her. After my babies are born, I have this overwhelming, all-consuming need to hold them close. I miss them. They have been with me for so many months. I do not want to be separated. That first night with Sara, I could not put her down. When I should have been sleeping, I stayed up, holding her little sleeping body to my chest. I could not even bear for her to be next to me in the bassinet. I needed--needed!--to feel her body and her breath on my skin.
Then, suddenly, I couldn't hold her anymore. One moment she was swaddled cozy in my arms, and the next she was stripped down to her diaper, a protective mask was attached to her temples with velcro, and she was placed loose and naked under the lights, where she seemed so vulnerable. We could take her out every three hours to feed her, but she couldn't be out for more than an hour.
Those precious single hours when she was out of the lights were stressful. Feeding her was crucial. She wouldn't get better unless she could eat and pass the bilirubin out of her body. But feeding her wasn't easy. Since she entered the world without a journey down the birth canal, the mucus hadn't been squeezed out of her. Instead, it filled her tummy, so she was simply not very hungry in those early days. To make matters worse, as the bilirubin level rose, she became more and more lethargic, a common symptom. Feeding a 2-day-old who is not hungry and not awake is pretty much ... not possible. Even more complicated is that cute little chin of Sara's. Her jaw bone protrudes at the chin (the doctor has some fancy Latin name for it), enough to interfere with her ability to latch on. She can do it, which is a blessing. But it's tricky for her (even now at the ripe age of 7 weeks). Needless to say, breastfeeding was not going well.
Not only could I no longer hold my baby, but I soon had to make quick decisions about feeding. Things I'd never thought about before--pumping and supplemental nursing systems and finger feeding and formula. Looking back, these do not seems like particularly challenging topics. But in my super emotional-hormonal-delirious-sleep-deprived state, each decision seemed monumental and overwhelming. I have to credit the pediatricians and especially the nurses and lactation consultants for helping me find a good balance between the urgent matter of getting fluids into my baby and the long term importance of establishing breastfeeding. (I think this is the first time I am breastfeeding because of lactation consultants and not despite them! They were wonderful at St. Mary's.)
Even once the decisions were made, feeding time was stressful. We would get Sara, change her diaper, and then try to get her to latch on--which was only successful occasionally, and then only if I had two other sets of hands to help me. (This was my third baby! And it took a nurse AND a lactation consultant BOTH for me to have any chance of getting her latched on. Sheesh--I felt like such a novice.) After it was clear breastfeeding was not going to work at that feeding (which was almost every time, meaning the few precious minutes I did have with her were spent in frustration), Greg would finger feed her formula while I pumped like a mad woman trying to get my milk to come in sooner. (Eventually we were able to switch from formula to colostrum, thanks to all that pumping.) Then I would sneak in a couple of minutes of cuddles and kisses. And then back she would go. We would cover her eyes with her mask, lay her exposed in the bed, give her a pacifier, and hope she would be okay looking so lonely and vulnerable. (I have a new appreciation for moms whose babies are in the NICU. This was nothing like that. But I have a teensy tiny bit better understanding of how emotionally difficult it would be to have your baby in an incubator.)
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| Greg keeps Sara alive. He was so good at getting her to eat enough that the nurses absolutely adored him. (Me too, of course!) |
We settled into our routine. Not the routine I had imagined. But a routine that would lead to a healthy baby.
While all of this was going on, don't forget that I was recovering from surgery. Something as simple as getting out of bed, walking over to a chair, sitting in the chair, and then positioning a baby to nurse was painful and exhausting. At first, going to the bathroom was like climbing Mount Everest (but by the end it was only like climbing Pike's Peak.) Between worrying about Sara and caring for her, I tried to squeeze in sleep and eating and showering. It was so crazy that it was several days before I even left the hospital room! Soon I tried to find a few minutes here and there to walk the halls to help me recover faster. The best way to describe how I felt is overwhelmed. Trying to care for myself (which I recognized was important) on top of feeling stressed out about my baby's situation was incredibly overwhelming for me.
But, like I said, we settled into a routine. I wasn't able to care for Sara myself, even with help from nurses. So Greg spent a lot of time with me--the most time we've spent together in years. But he also needed to help care for David and Mary. So my mom usually stayed with me for a chunk of the day. She learned to finger feed Sara. And my dear friend Shawna came to help in the evenings. She, too, learned to feed Sara. Then Greg would come to spend the night. He would pull out the chair and curl up in his gray sweatshirt until the nurse brought Sara to us for a feeding.
Sara's bilirubin levels continued to rise, but that was to be expected. The important thing is that she was not in the danger zone. The real test would be at about day 4, when bilirubin levels can spike up. Would that happen? That would be the make or break day. Here levels would spike towards a dangerous level. Or she would be safe and soon on her way home.
So it was a waiting game, as we trudged along with the treatment. The real question was whether or not Sara would be able to come home with me. If I had not had a C-section, I would have left the hospital without my baby. The phototherapy she needed was much more intense than we could have given her at home. Sara was born Friday morning. My doctor and I thought I would probably go home Monday. Over the weekend, though, when it became apparent this little girl wasn't going home anytime soon, my doctor and I decided I would stay until Tuesday, the latest my insurance would allow.
I was a wreck on Monday. I had yet to get Sara to nurse without a lot of professional help. I was still in a lot of pain. And I had to face the reality that Sara might not be going home with me the next day.
But I was so grateful that I had been able to be with Sara in the hospital. She was not in the NICU, so the nurses would move her big light set-up piece by piece down to my room. I could not hold her. I couldn't even see her from where I rested in bed. But I knew she was near. We were together. What a blessing to be in close proximity to her. What a blessing for Sara and me to be cared for by the same nurses. As overwhelmed as I felt, I could recognize how much simpler my life was because I could stay in the hospital with Sara. Yes, I worried about David and Mary. I longed for their visits. But I was grateful for that hospital room--a peaceful little bubble protected from the chaos of the outside world where I could focus on Sara and getting her better. Such simple logistics were a true blessing.
I think there are a lot of reasons why I felt like I should have a C-section. I figure most of the reasons only God will know. But I cannot help but recognize what a blessing it was to be able to be in the hospital with Sara. How thankful I am that I was not sent home without her, that I had those extras days with her because I had had the C-section.
So, yes, come Tuesday morning we learned that we would be discharged together. I would have wept, except that I had already wept so much over those few, intense days. What I relief I felt when the pediatrician came in and announced that Sara could go home that day. And her levels were so good that we didn't even have to continue any phototherapy at home. Hooray!
I was feeling much, much better physically by Tuesday. Sara had even latched on Monday night without professional help, so I felt more confident in my ability to establish breastfeeding with her. Greg diligently gathered the supplies we would need to finger feed her at home, and Shawna gave us her super awesome breast pump, which would be essential. So I knew that we would be able to keep her alive once we got her home!
I'm not sure I have ever felt such a sense of relief. I felt as light as a feather. At the same time, my heart felt a thousand times bigger than normal, and it was overflowing with gratitude. I was so thankful for the loving, competent, patient, well-qualified nurses. It was a tender time for our family, and their physical and emotional help was invaluable. I loved each nurse who served us. Who cares about St. Mary's fancy rooms and yummy milkshakes--it was the amazing nursing staff that made all the difference.
I was also so very grateful for my mom. She cared for David and Mary, including getting them to school in the morning, which is no small task. I knew I did not have to worry about David and Mary being taken care of. Trust me, I didn't need one more thing to worry about. I'm also thankful for the time she spent in the hospital room with me. I could have Sara in the room with me, but only if someone else was there too to monitor Sara at all times. My mom spent hours sitting in the chair next to Sara. I am grateful for her support and sympathy.
My heart is also full of gratitude for my friend Shawna. Our time in the hospital was not a time for casual visitors. It was a busy, intense, but sacred time. While things were not scary, it wasn't a light-hearted, happy time. (It would have been an untruth to announce, "Mom and baby are doing well.") But Shawna was not a casual visitor stopping by to merely wish congratulations. She came to serve me and Sara. My heart overflows with gratitude for her quiet, Christ-like service. It was a tender time for me, and being with Shawna, who has a sweet, tender heart, was a balm for my worried spirit.
Most of all, I am grateful for Greg. I cannot write about it because I do not know how to express the feelings in my heart. I married a good, good man.
Finally, after several intense days of working hard together for our Sara, Greg and I would be able to take her home. All three of us together.
Tuesday was a happy, happy day.
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| Greg, my hero, holds Sara on Tuesday morning. After not being able to hold her for three and a half days, we couldn't put her down. We still can't. |
